Metastatic craniopharyngioma: case report and literature review

Frangou, Evan; Tynan, Jennifer R.; Robinson, Christopher A.; Ogieglo, Lissa; Vitali, A

doi:10.1007/s00381-009-0917-4

Cited by 32 publications

(11 citation statements)

References 31 publications

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“…Indeed, we have found only one study where this was discussed as a concept—a report on metastatic craniopharyngioma in children; it was not, however, recognised in their own patient 12. Jun Hyong Ahn and group described the likelihood of surgical spillage of malignant cells into the leptomeninges during the neurosurgical resection of brain metastases 4.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung

Tinsley¹,

Yemula

Ramalingam

et al. 2018

BMJ Case Reports

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A 72-year-old man was brought to the emergency department with acute onset confusion and haemoptysis. Chest X-ray showed a possible lung mass, while CT head showed a fluid-filled, space-occupying lesion (SOL) in the right frontal lobe of the brain. MRI head indicated that this SOL had spilt its contents into the subarachnoid and intraventricular spaces. Due to a fluctuating Glasgow Coma Scale (GCS), the patient underwent emergency debulking. Macroscopically, a frail-walled cystic tumour filled with straw-coloured fluid was noted; histology confirmed metastasis from a primary lung adenocarcinoma. Whole brain radiotherapy was given, with a view to commence systemic therapy. The patient, however, deteriorated and unfortunately passed away a few weeks after completing radiotherapy. This patient presented with leptomeningeal metastasis as the first presentation of a lung adenocarcinoma, and had a highly unusual mechanism by which leptomeningeal spread had occurred, with metastatic brain tumour spilling its contents into the meningeal spaces.

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Section: Discussionmentioning

confidence: 99%

An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung

Tinsley¹,

Yemula

Ramalingam

et al. 2018

BMJ Case Reports

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“…Most of the recurrent craniopharyngiomas had the same site of origin and growth patterns as the primary tumor, although these lesions can recur at a distant site. 1,6,8,9,17 symptoms and signs Delayed puberty was significantly more frequent in children with Type I than Type TS craniopharyngioma. For children with the Type I tumor, the GH replacement therapy might be emphasized.…”

Section: Discussion Growth Pattern Of Recurrent Craniopharyngiomasmentioning

confidence: 98%

Origin of craniopharyngiomas: implications for growth pattern, clinical characteristics, and outcomes of tumor recurrence

Bao¹,

Qi²,

Lu³

et al. 2016

JNS

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C raniopharyngioma, representing 1.2%-4.4% of CNS tumors, can still be challenging. Although its histology is benign, this tumor is associated with a high rate of recurrence. 22 Recurrent craniopharyngiomas are associated with high morbidity because of the tumor's proximity to vital structures, including the pituitary stalk, hypothalamus, optic apparatus, and vessels in the circle of Willis.Various strategies have been advocated to improve patient outcomes. Total resection of recurrent craniopharyngioma remains a challenge even in experienced hands, particularly if the lesion involves the hypothalamus and the third ventricle, because of the associated risk of hypothalamic injury. 20 Loss of arachnoid interposed between the craniopharyngioma and the surrounding hypothalamus has been proposed as a main reason for the higher abbreviatioNs ACTH = adrenocorticotropic hormone; BMI = body mass index; DI = diabetes insipidus; FSH = follicle-stimulating hormone; GH = growth hormone; KPS = Karnofsky Performance Scale; LH = luteinizing hormone; TSH = thyroid-stimulating hormone. Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China obJective Craniopharyngiomas are associated with a high rate of recurrence. The surgical management of recurrent lesions has been among the most challenging neurosurgical procedures because of the craniopharyngioma's complex topographical relationship with surrounding structures. The aim of this study was to define the determinative role of the site of origin on the growth pattern and clinical features of recurrent craniopharyngiomas. methods The authors performed a retrospective analysis of 52 patients who had undergone uniform treatment by a single surgeon. For each patient, data concerning symptoms and signs, imaging features, hypothalamic-pituitary function, and recurrence-free survival rate were collected. results For children, delayed puberty was more frequent in the group with Type I (infradiaphragmatic) craniopharyngioma than in the group with Type TS (tuberoinfundibular and suprasellar extraventricular) lesions (p < 0.05). For adults, blindness was more frequent in the Type I group than in the Type TS group (p < 0.05). Nausea or vomiting, delayed puberty, and growth retardation were more frequent in children than in adults (p < 0.05). Overall clinical outcome was good in 48.07% of the patients and poor in 51.92%. Patients with Type TS recurrent tumors had significantly worse functional outcomes and hypothalamic function than patients with the Type I recurrent tumors but better pituitary function especially in children. coNclusioNs The origin of recurrent craniopharyngiomas significantly affected the symptoms, signs, functional outcomes, and hypothalamic-pituitary functions of patients undergoing repeated surgery. Differences in tumor growth patterns and site of origin should be considered when one is comparing outcomes and survival across treatment paradigms in patients with recurrent craniopharyngiomas.

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“…Unusual cases in other compartments without connection to the sellar / suprasellar region could originate from mismigrated Rathke ' s cleft cell. While sometimes multi-lobular, primary ectopic craniopharyngioma are not truly multi-focal, see references in [2] . Secondary ectopic craniopharyngioma are also rare event not observed so far in the HIT-Endo study (306 patients), KRANIOPHARYNGEOM 2000 study (125 patients) or the ongoing prospective KRANIOPHARYNGEOM 2007 study (71 patients as of 10 / 2010), with a median follow-up time of 6.0 years (range: 0.1 -36.5 years).…”

Section: Discussion ▼mentioning

confidence: 99%

Ectopic Craniopharyngioma

et al. 2011

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Metastatic craniopharyngioma: case report and literature review

Abstract: A review of reported cases suggests that leptomeningeal implantation may be an important step in metastases of craniopharyngioma, although the mechanism is poorly understood. Attention to tumor spillage at the time of surgery may be important in preventing distant recurrences.

Cited by 32 publications

References 31 publications

An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung

An unusual case of leptomeningeal carcinomatosis in a patient with primary adenocarcinoma of the lung

Origin of craniopharyngiomas: implications for growth pattern, clinical characteristics, and outcomes of tumor recurrence

Ectopic Craniopharyngioma

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